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If you have questions or comments and for what it's worth, here is my regimen. It is marginally successful but if I veer off this road, the results are unpredictable. Incidentally, I have chemo two weeks on, one week off. Diagnosis biliary cancer, stage 4. Diagnosed after MRI in response to severe upper back pain. The MRI was prescribed by a senior resident when my attending was not available. My attending was focussed on the musculature and did not entertain, at least in my presence, the possibility of cancer. My attending did not belive in periodic xrays and I had not had one in 9 years, although Iam not certain that xray would have seen the small lesions. Pathology could not positively identify the type of my cancer and suggested that the stain most resembled biliary cancer. The primary site no longer existed, which made things harder of course. I don't know that I would be eligible for any trials for this reason. So, I'm just waiting it out, fighting the weight battle and tidying up my affairs. My oncologist focussed on quality of life. I am somewhat blessed in that I experience minimal nausea (only from my pain meds at home). I have all my hair but that'snot a critical issue. My oncologist does not have a a group of other professionals, such as oncological social workers and nutrionists, which makes me feel a bit isolated. I am now reaching out to cancercare for this support. And the meds...Zometa plus two others which I don't recall. As for pain, Oxycontin (really helpful), Dilaudid to fill in the gaps from the Oxy CR, and various narrow range meds for specific maladies (flomax, lisinopril hctz, wellbutrin). Optional are Celebrex, Fle eril. High protein drinks are a life saver but do get boring after a while. That's it. By the way, since this is being typed on an iPhone, correction of typos is very hard, so I have left them in. You'll be able to figure them out. Best to all, R.

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